POS0208-HPR PATIENT CHARACTERISTICS AND DIAGNOSIS SETTING OF PATIENTS WITH PAIN ASSOCIATED WITH OSTEOARTHRITIS OF THE KNEE IN GERMANY: A RETROSPECTIVE HEALTH CLAIMS DATA ANALYSIS
Authors: D. Beier, D. Haeckl, S. Ivanavicius, J. Jerosch, H. Liedgens
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Osteoarthritis of the knee (knee OA) is the most prevalent form of OA in Germany as well as globally<sup>[1]</sup>, frequently leading to pain and functional limitations. Several risk factors have been identified for osteoarthritis, which can be divided into those at the person level (age, sex, obesity, genetic predisposition, physical activity and diet) and those at the joint level (injuries, malposition and overstress)<sup>[2]</sup>. Patients with OA-like symptoms may present to a number of different medical specialties and therefore arrive at a diagnosis of Knee OA via different routes. The Knee OA population is a highly co-morbid one. In addition to obesity, Knee OA patients often present with hypertension and diabetes<sup>[3]</sup>. <h3>Objectives</h3> The study focuses on knee OA in Germany, aiming to determine the prevalence of OA in the years 2015-2020, diagnosis setting and comorbidities of patients between 2015 and 2020. <h3>Methods</h3> A non-interventional, retrospective health claims data analysis, performed with anonymized, age- and sex-representative sample of the Institute for Applied Health Research Berlin GmbH (InGef) database. The database used for this study includes approximately 4.8 million persons from approx. 60 statutory health insurances (SHI) and is representative for the German population [6]. Patients ≥18 years of age were analyzed cross-sectionally for each year 2015-2020. Using ICD-10-GM and ATC codes. <h3>Results</h3> The prevalence of knee OA ranged from 7.1% in 2015 to 7.6% in 2019, dropping to 7.4% in 2020. The incidence showed a less linear pattern ranging from 1.71% of patients in 2015 and 2016, 1.67% in 2017, 1.61% in 2018, 1.67 in 2019 to 1.46% of patients in 2020. Females and patients aged ≥66 years had both a higher prevalence and incidence proportion compared to males and younger persons. First diagnosis for most patients was made in an outpatient setting (93.4%) by orthopedics (49.88%), general practitioners (28.17%) and specialists (Internist; 9.34%). Most prevalent co-morbidities for patients with Knee OA in all years observed was primary hypertension with &gt;70%. Other metabolic disorders like disorders of lipoprotein metabolism (around 50%), overweight and obesity (28-30%), type 2 diabetes mellitus (around 27%) are among the 10 most common ones. Other musculoskeletal disorders are frequent (dorsalgia 54%; spondylosis 33-34%). The percentage of patients with major depressive disorders is high in all years (23%). <h3>Conclusion</h3> The number of patients with knee OA is slowly increasing from 2015-2019 possibly due to the growing German population, however slightly decreasing in 2020. Diagnosis is mainly done by an orthopedist or general practitioner. The increasing number of certain co-morbidities, mainly of the cardiovascular system (hypertension with the highest percentage), but also due to metabolic condition (Disorders of lipoprotein metabolism and other lipidemias, overweight and obesity, type 2 diabetes) demonstrates that the percentage of patients with known risk factors for knee OA is increasing. Treating pain in patients with co-morbidities can be challenging due to managing drug-drug interactions given the considerable number of treatments patients could be receiving. This can be a high risk for these patients as physicians do not always know about non-prescription co-medications. Models of care for patients with knee OA which include tolerable, non-systemic pain treatments, enabling patient physiotherapy and management of other aspects of their health actively may be a key advancement. <h3>References</h3> [1]Woolf AD, Pfleger B (2003) Burden of major musculoskeletal conditions. Bull World Health Organ 81(9):646-656 [2]Fuchs J, Kuhnert R, Scheidt-Nave C. (2017) 12-month prevalence of osteoarthritis in Germany. Journal of Health Monitoring · 2(3) DOI 10.17886/RKI-GBE-2017-066 Robert Koch Institute, Berlin [3]Ludwig M., Enders D., Basedow J. et al. (2022) Sampling strategy, characteristics and representativeness of the InGef research database. Public Health 206: 57-62 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Dominik Beier Consultant of: Consultancy with Grunenthal GmbH, Dennis Haeckl Consultant of: Consultancy with Grunenthal GmbH, Stefan Ivanavicius Employee of: Employee of Grunenthal GmbH, Jörg Jerosch Consultant of: Consultancy with Grunenthal GmbH, Hiltrud Liedgens Employee of: Employee of Grunenthal GmbH.